“Mom, what is sex?” My Eight-year-old son asked me recently. After almost drowning with my Cheerios, I was able to investigate further and discovered that, luckily, it only referred to gender. I had gained a little more time to prepare for a bigger conversation. I admit it, I felt relieved. While sex is a normal and healthy part of life, talking about it can sometimes be a bit awkward. Still, if you have medical concerns about sex, you should talk to your doctor. One of the questions I hear from my patients is whether it is safe to have sex at certain times. Medically, there are only a few cases in which sex should be avoided.
- Before a Pap test
The Pap test has improved over the years, but basic technology still involves the analysis of individual cells under the microscope. Semen can make the Pap test less sensitive, so you should avoid sex the night before your annual exam. Honestly, your gynecologist would probably prefer not to find semen during an exam, so it would be polite to abstain before any pelvic exam, Pap test or not.
- Unexplained vaginal bleeding or pain
Most women will experience occasional stains or pangs of pain with ovulation, but if you experience persistent pain or bleeding, then you should avoid having sex. Pain during sexual intercourse or bleeding after sexual intercourse may be signs of cervical abnormalities and should request a visit from your provider.
- Postpartum
Most women will experience a certain amount of tears after a vaginal birth, and even patients who are lucky to avoid stitches often have abrasions on the lips that can be very sensitive. Having sex before the vagina is fully healed can cause wounds to reopen and increase the risk of infection, not to mention pain as heck.
- When you have an infection
If you experience symptoms of pelvic or vaginal infection, such as a foul-smelling discharge, severe vaginal itching, burning or pelvic pain, you should avoid having sex until you see a doctor. Having sex with a vaginal infection is not only painful, but it can cause the infection to spread to the pelvic organs and become more serious, and obviously, if it is a contagious infection, you will not want your partner to be exposed.
- After surgery
This may seem common sense, but on several occasions I have had patients with significant complications after hysterectomies caused by having sex too soon. Surgical advances have allowed patients to recover faster and return to normal much faster than before. However, sometimes, even if someone feels good, their guts continue to heal. With all surgeries, you should consult with your surgeon when it would be appropriate to resume sexual intercourse.
For the average healthy woman, there are not many occasions when sex is not advised from a medical point of view. If you have pain, bleeding or have had a baby or surgery recently, please refrain. If you have other medical concerns, consult your doctor. While talking about sex can be uncomfortable for some patients, it is likely that your gynecologist has already had several sexual conversations that day, perhaps even at breakfast.
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